News: More EHR implementation issues arise for VA, audit finds

After a series of problems and delays in their implementation of a new EHR modernization (EHRM) program, more issues have surfaced despite the Department of Veterans Affairs' (VA) efforts. The Department of Defense (DOD) Office of Inspector General (OIG) recently audited the program and found problems with its current data migration, interface usage, and user access.

The EHRM program was created to connect and improve data exchange between the DOD, the VA, and external health providers. The goal of its implementation is to increase EHR interoperability, or “the ability to exchange EHRs securely with other health information technology systems without special effort on the part of the user,” according to the DOD OIG audit. If successful, this could lead to enhanced patient care and healthcare provider effectiveness.

According to the audit, the DOD and VA did not take all needed actions for interoperability, however, possibly in part because the oversight committee (FERHM) had little active engagement in the program. The DOD OIG only became involved when disputes arose between the DOD and VA, Healthcare Dive reported, facilitating discussions that created separate departmental actions to migrate data, develop interfaces, and grant user access, instead of creating a standard one.

Because of this, the audit says the office failed to:

• “Consistently migrate patient health care information from the legacy electronic health care systems into Cerner Millennium to create a single, complete patient EHR;
• Develop interfaces from all medical devices to Cerner Millennium so that patient health care information will automatically upload to the system from those devices; or
• Ensure that users were granted access to Cerner Millennium for only the information needed to perform their duties.”

Among other things, the audit recommended the FERHM program director develop and implement plans to create interfaces for medical devices that will easily connect and transfer data to the new EHR platform, modify user roles to better limit patient information, and migrate patient information after defining the type of healthcare information that constitutes a complete EHR.

In the meantime, the VA OIG estimates the project will cost $21 billion overall and an additional $2 billion for every year it takes to finish moving forward.

Editor’s note: To read Healthcare Dive’s coverage of this story, click here. To read the full DOD OIG audit, click here. To read about earlier delays in the implementation process, click here.